Researchers at Intermountain Medical Center are hoping to eventually help improve the quality of life for people who have suffered a spinal cord injury with a unique study of newly injured patients.
While much is now understood about how spinal cord injuries affect people over the long-term, little is known about how the body’s major organs and systems — including heart and lung function, circulation, muscle tissue, bone density, hormone production and nutrition — are impacted within the first 60 days.
Treatment during that time period, known as the acute phase, may change over time as doctors learn more about how they may be able to counteract deterioration or use medication to alter the body’s own reaction to the injury, researchers said.
Dr. Mark Stevens, medical director of trauma services at IMC, said while there are studies under way elsewhere examining how cooling injured patients may lessen the damage they suffer, the new study at IMC will try to determine how quickly physiological changes unrelated to the central nervous system take place.
“There may be some surprises in terms of how things change with chemicals or hormones in the body,” he said. While some nerves are severed as part of the accident itself, “it’s possible we could help prevent damage” to nerves that were not completely severed by knowing what kind of early interventions to use.
By learning better how the body reacts in the first hours, days and weeks following the accident, “we may be able to prevent some of the secondary injury,” just as doctors now do with stroke patients by using early intervention techniques.
The study is being conducted in conjunction with researchers at the VA Medical Center in the Bronx, N.Y. Both hospitals hope to enroll spinal cord patients who would participate in regular examination of their blood, muscles, heart, lung function and other body processes to give researchers a better understanding of what happens outside the changes in the central nervous system.
Stevens said testing of spinal cord volunteers will include needle biopsies both above and below the injury to examine “molecular-level changes in the muscle or genetic expression in those cells. We’re not sure whether that will be fruitful or not, but we’re looking to see if there are changes” that take place in the cell process that can be altered.
To date, it’s been difficult for researchers to study the acute phase after a spinal cord injury because patients and their families experience so much trauma when someone becomes paralyzed. Officials at IMC hope to recruit them within 72 hours.
Ben Briggs, who works with the hospital’s trauma research team, hopes to enroll 12 patients locally in the study after trauma physicians have explained the research to their patients, so they understand it’s not some kind of “magic bullet.”
Because their injuries have already occurred, patients in the study won’t be treated any differently than other spinal cord patients. They will agree to undergo testing for up to two years following the injury.
“The greatest benefit to them will be that extra testing,” Briggs said. “They’ll have lots of information they wouldn’t normally get by doing these tests.”
Jolene Fox, a senior researcher with IMC trauma services, said the research to be done here will blend well with what the New York VA has learned about the rehabilitation phase of caring for spine injury patients and give context to the current treatment regimen. Most such injuries occur during falls — either elderly people at home or younger people with industrial accidents — or during motor vehicle crashes.
Stevens said there are about 10,000 new spinal cord injuries annually in the U.S. The Christopher and Dana Reeve Foundation reports more than 1.2 million people have been reported being paralyzed with such an injury — 52 percent are considered paraplegic, and 47 percent are quadriplegic.
By Carrie A. Moore